J Pathol Transl Med.  2022 Jan;56(1):57-60. 10.4132/jptm.2021.10.09.

Composite follicular lymphoma and classic Hodgkin lymphoma

• Kim HN
• Jeon MJ
• Yu ES
• Kim DS
• Choi CW
• Ko YH

• KMID: 2524231
• DOI: http://doi.org/10.4132/jptm.2021.10.09

Abstract

Composite lymphoma is very rare and a combination of Hodgkin lymphoma and non-Hodgkin lymphoma and even histiocytic tumors can occur. Because of the unfamiliarity, not only can this cause diagnostic problems, but can also affect treatment plan. We report a case of composite lymphoma in a 40-year-old male. Initial biopsy showed a composite lymphoma of follicular lymphoma grade 1 and classic Hodgkin lymphoma. After chemotherapy, another lymph node was taken because of disease progression, which revealed follicular lymphoma, grade 3a without Hodgkin lymphoma component.

Keyword

Composite lymphoma; Follicular lymphoma; Hodgkin lymphoma

Figure

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  Fig. 1 Composite follicular lymphoma and Hodgkin lymphoma of initial biopsy. (A) Lymph node shows nodular area representing follicular lymphoma and diffuse area containing Hodgkin lymphoma. (B) Follicular lymphoma, grade 1. (C) Reed-Sternberg cells of Hodgkin lymphoma. (D) CD10-positive cells of follicular lymphoma. (E) BCL2-positive follicular lymphoma. (F) CD21-positve follicular dendritic cell meshwork of follicular lymphoma. (G) CD30 in Reed-Sternberg cells. (H) CD15 in Reed-Sternberg cells. (I) PAX5 weak positive in Reed-Sternberg cells (arrows).

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  Fig. 2 (A–C) Composite follicular lymphoma and Hodgkin lymphoma of initial biopsy. Double stain for CD10 to show follicular lymphoma (brown) and CD30 to identify Hodgkin lymphoma (red). (A) CD30-positive Reed-Sternberg cells (arrows) are scattered in between follicular lymphoma. (B) A few CD30-positive Reed-Sternberg cells (arrow) within neoplastic follicles of follicular lymphoma. (C) Diffuse permeation of Hodgkin lymphoma to follicular lymphoma area. Reed-Sternberg cells (arrow) are scattered in diffuse area and small nodular remnant of neoplastic follicles. (D–F) Follicular lymphoma of recurrent lesion: (D) follicular lymphoma, grade 3a, (E) CD10, (F) BCL2.

Reference

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